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Femoral Neck Stress Fracture

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243. Paediatric Urology

testis can generally be brought into the scrotum, where it will remain until a cremasteric reflex (touching the inner thigh skin) retracts it into the groin [36]. A unilateral, non-palpable testis and an enlarged contralateral testis suggest testicular absence or atrophy, but this is not a specific finding and does not preclude surgical exploration. An inguinal, non-palpable testis requires specific visual inspection of the femoral, penile and perineal regions to exclude an ectopic testis. Diagnostic (...) to the testes, by a mechanism that is not clearly understood. Genetic factors may be present. An anatomic abnormality leading to impaired venous drainage is expressed by the considerable prevalence of the left side condition where the internal spermatic vein drains into the renal vein. Varicocele can induce apoptotic pathways because of heat stress, androgen deprivation and accumulation of toxic materials. Severe damage is found in 20% of adolescents affected, with abnormal findings in 46% of affected

2015 European Association of Urology

244. Chronic Pelvic Pain

that pathways for specific or combinations of stimuli may become established, resulting in an individual being vulnerable to perceiving sensations that would not normally be experienced as painful. Stress can modify the nervous system to produce long-term biological changes. These structural changes may be responsible for significant early life and adverse life events which are associated with chronic pain syndromes [26]. The patient should be asked about significant adverse life events, which may produce (...) significant end-organ dysfunction. These functional abnormalities can have a significant effect on quality of life (QoL) and must be managed as appropriate. 2.2.8 Endocrine system The endocrine system is involved in visceral function. Significant life events, and in particular, early life events may alter the development of the hypothalamic-pituitary-adrenal axis and the chemicals released. Increased vulnerability to stress may occur following such events and is thought to be partly due to increased

2015 European Association of Urology

245. Prostate Cancer

focused ultrasound 72 6.8.6 Cryotherapy 72 6.8.7 Hormonal therapy 73 6.8.7.1 Side-effects, quality of life and cost of hormonal therapy 73 6.8.7.1.1 Sexual function 73 6.8.7.1.2 Hot flushes 73 6.8.7.1.3 Other systemic side-effects of androgen-deprivation therapy 73 6.8.7.1.3.1 Non-metastatic bone fractures 73 6.8.7.1.3.2 Metabolic effects 74 6.8.7.1.3.3 Cardiovascular morbidity 74 6.8.7.1.3.4 Fatigue 75 6.8.8 Comparison of health-related quality of life between treatment modalities 75 6.8.9 Guidelines (...) the prostate 1 T2a Tumour involves one half of one lobe or less T2b Tumour involves more than half of one lobe, but not both lobes T2c Tumour involves both lobes T3 Tumour extends through the prostatic capsule 2 T3a Extracapsular extension (unilateral or bilateral) including microscopic bladder neck involvement T3b Tumour invades seminal vesicle(s) T4 Tumour is fixed or invades adjacent structures other than seminal vesicles: external sphincter, rectum, levator muscles, and/or pelvic wall N - Regional

2015 European Association of Urology

246. Imaging after Total Hip Arthroplasty

tissues around metal components [8-10]. Osteolysis, implant position, hardware integrity, wear, fractures, heterotopic ossification, hematomas, and fluid collections can be assessed [7,11]. Dual-energy CT can reduce artifacts due to metal prostheses and reduce the radiation dose [7,8,12]. Quantitative CT: Quantitative CT allows the remodeling of trabecular and cortical bone near an acetabular or femoral component to be assessed [13,14]. However, this remains largely a research tool. Magnetic resonance (...) and the patient is asymptomatic, there is no clear need to routinely check metal ion levels in the blood or to perform soft-tissue imaging (such as MRI) [47]. Bone scan: Bone scan appearances after THA are variable, reflecting the stress on the adjacent bone as well as any complications that occur. One study of asymptomatic cemented total hip prostheses indicated that persistent increased uptake could be seen at the tip of the femoral stem in about 10% of patients up to 3 years after surgery, at the greater

2015 American College of Radiology

247. Revised ATA guidelines for the management of medullary thyroid carcinoma

guidelines. After subsequent revisions and critical reviewsofaseriesofdraftstheTaskForcedevelopeda?nal document. The consensus was most often unanimous; how- ever,onsomeissuesthereweredisparateviewsamongTask Force members, which are noted in thedocument. The ATA Board of Directors approved the ?nal document, and it was subsequently endorsed by the American Academy of Pedia- trics; American Association of Clinical Endocrinologists; American Association of Endocrine Surgeons; American Head & Neck Society (...) ; American Society of Pediatric He- matology/Oncology;AustralianandNewZealandEndocrine Surgeons; British Association of Head and Neck Oncolo- gists; British Nuclear Medicine Society; European Thyroid Association;InternationalAssociationofEndocrineSurgeons; International Federation of Head and Neck Oncologic Socie- ties; Italian Endocrine Society; Korean Society of Thyroid- Head and Neck Surgery; Latin American Thyroid Society; Pediatric Endocrine Society; and The Endocrine Society. Literature review

2015 Pediatric Endocrine Society

248. Kadcyla (trastuzumab emtansine (genetical recombination))

studies for drug substance Manufacturing process Number of batches Storage conditions Study period Storage configuration Long-term testing Manufacturing process D 1 -20°C 36 months ******** tank 1 ** months * Commercial manufacturing process 3 ** months * 3 ** months * Accelerated testing Manufacturing process D 2 5 ± 3°C 3 months Commercial manufacturing process 3 3 months 3 6 months Stress testing Manufacturing process D 1 25°C/60% RH 1 month Glass vials 3 40°C/75% RH Commercial manufacturing (...) ***************************************************************************** ***************************************************************************** ***************************************************************************** ***************************************************************************** ***************. 2.A.(2).5) Stability of drug product The main stability studies for the drug product are as shown in the table below. Outline of the stability studies for drug product Formulation Number of batches Storage conditions Study period Storage configuration Long-term testing 100 mg 3 5 ± 3°C ** months *1 Glass vials 160 mg 4 ** months *1 1 36 months Accelerated testing 100 mg 3 25°C/60% RH 6 months 160 mg 5 Stress testing 100 mg 3 50°C/75% RH 6 months 160 mg 4 Photostability testing 100 mg 1 =1.20

2013 Pharmaceuticals and Medical Devices Agency, Japan

249. ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management Full Text available with Trip Pro

resynchronization therapy CRT-D cardiac resynchronization therapy de?brillator CT computed tomography cTnI cardiac troponin I cTnT cardiac troponin T CVD cardiovascular disease CYP3a4 cytochrome P3a4 enzyme DAPT dual anti-platelet therapy DECREASE Dutch EchocardiographicCardiacRisk Evaluation Apply- ing Stress Echocardiography DES drug-eluting stent DIPOM DIabetic Post-Operative Mortality and Morbidity DSE dobutamine stress echocardiography ECG electrocardiography/electrocardiographically/electro- cardiogram (...) stress. In the case of peri- operative myocardial ischaemia, two mechanisms are important: (i) a mismatch in the supply–demand ratio of blood ?ow, in response to metabolic demand due to a coronary artery stenosis that may become ?ow-limiting by perioperative haemodynamic ?uctuations and (ii) acute coronary syndromes (ACS) due to stress-induced rupture of a vulnerable atherosclerotic plaque in combination with vascular in?ammation and altered vasomotion, as well as haemosta- sis. LV dysfunction

2014 European Society of Cardiology

251. Long term follow up of survivors of childhood cancer

in their protocol have a slight reduction in lumbar spine BMD and apparently normal femoral neck-BMD. 169 Femoral neck BMD is affected in those children who received high dose of MTx and GCs compared with age matched healthy controls. 157 6.3.3. CRANIAL IRRADIATION Cranial irradiation is reported to have a detrimental effect on BMD and bone growth in ALL survivors. 157 This may result from damage to the hypothalamic-pituitary axis, which leads to growth hormone deficiency (GHD). Some data show that cranial (...) to growth hormone therapy shows conflicting results. 170,180 Endocrine evaluation is recommended for childhood cancer survivors who have a significant reduction in bone mineral density and/or recurrent fractures. 6.5.3 BISPHOSPHONATES No evidence was identified on the use of bisphosphonates in childhood cancer survivors. Long term follow up of survivors of childhood cancer3 3 3 | 25 7 Metabolic syndrome 7.1 INTRoDuCTIoN Metabolic syndrome is associated with premature death due to macrovascular

2013 SIGN

252. Acute Pain Management: Scientific Evidence

Safety and complications related to PCA 248 6.7 Equipment 249 6.7.1 Programmable PCA pumps 249 6.7.2 Disposable PCA devices 249 6.7.3 Equipment-related complications 250 6.8 Patient and staff factors 251 6.8.1 Patient factors 251 6.8.2 Nursing and medical staff 251 6.9 PCA in specific patient groups 252 References 253 7. NONPHARMACOLOGICAL TECHNIQUES 259 7.1 Psychological interventions 259 7.1.1 Provision of information 259 7.1.2 Stress and arousal reduction 260 7.1.3 Attentional techniques 261 7.1.4 (...) approaches aimed at fear avoidance (N) (Level I [PRISMA]). 2. There is significant association between anxiety, pain catastrophising ( N) (Level III-2 SR), depression, psychological vulnerability and stress (N) (Level IV SR) and the subsequent development of chronic postsurgical pain. 3. There is a significant association between high levels of catastrophising in acute and subacute back pain and pain and disability at later points of time (N) (Level III-2 SR ). 4. Preoperative anxiety (S) (Level IV SR

2015 Clinical Practice Guidelines Portal

253. Erivedge - vismodegib

treatments. In these cases progressive disease results in morbidity from local tissue invasion and destruction particularly on the face, head and neck. These lesions include both locally advanced BCCs, that are either inoperable or in patients who have medical contraindications to surgery and for whom radiotherapy was unsuccessful or contraindicated, or very rarely, metastatic BCC, in whom BCC has spread to distant sites 3, 4, 5 . There are no published data on prevalence and life expectancy for locally (...) are available for all batches and up to 24 months of data have been reported for the 30 °C/65% RH condition. The batches are monitored for appearance, water content, assay, and impurities and physical form. All results reported are within proposed specifications. No trends are seen in the primary and supportive studies. The active substance has also been subjected to forced degradation with regards to acid, base, peroxide (oxidant), heat, humidity, and light stress conditions. Vismodegib is stable under

2013 European Medicines Agency - EPARs

254. Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions

using www.orthopt.org and www.jospt.org Physical Therapy National Outcomes Data Registry Support the ongoing usage of data registry for common musculoskeletal conditions of the head and neck region Logical Observation Identi?ers Names and Codes mapping Publication of minimal data sets and their corresponding Logical Observation Identi?ers Names and Codes for the head and neck region on www.orthopt.org Non-English versions of the guidelines and guideline implementation tools Development (...) - lar cartilage lesions are greater than grade 3 lesions on the International Cartilage Repair Society (ICRS) grading sys- tem. 36,130 The ICRS cartilage injury classi?cation consists of 5 grading levels, from grade 0 (normal cartilage without no- table defects) to grade 4 (severely abnormal, full-thickness osteochondral injury). 21 The most frequent localizations of cartilage lesions were to the medial femoral condyle and the patellar articular surface. 139 Medial meniscal tears (37%) and ACL

2018 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

255. Elelyso - taliglucerase alfa

protuberance. Hepatocellular function is usually well preserved, although transaminases may be slightly elevated. Splenomegaly is associated with hypersplenism and pancytopenia, with anaemia and thrombocytopenia being most significant. Bone involvement is caused by accumulation in marrow macrophages, a decrease in osteoblast activity and bone mineralisation, and a relative increase in bone resorption. The resultant osteopoenia predisposes to vertebral compression and other pathological fractures. Pulmonary

2012 European Medicines Agency - EPARs

256. Perampanel (Fycompa)

disease studies resulting from post-surgical complications following injuries (hip fracture, femoral neck fracture, and cervical hematoma after a fall in a patient who had previously reported somnolence as an AE). There were 3 deaths due to malignancies 1 “primary chest malignancy”, 1 malignant lung neoplasm, and 1 metastatic adenocarcinoma. Neoplasms are discussed in more detail in Section 7.6 of Dr. Doi’s review. There was 1 death due to pancreatitis; cholelithiasis and pancreatitis are discussed

2012 FDA - Drug Approval Package

257. Post-menopausal Hormone Treatment Update (DOPS, KEEPS)

in the spine and femoral neck and reduces risk of vertebral fracture. Ettinger B, Pressman A, Schein J, Chan J, Silver P, Connolly N. Alendronate use among 812 women: prevalence of gastrointestinal complaints, noncompliance with patient instructions, and discontinuation. J Managed Care Pharm 1998;4:488-92. Favus Murray J., Bisphosphonates for Osteoporosis. N Engl J Med 2010; 363:2027-2035. FDA July/11 notified healthcare professionals and patients about its ongoing review of data from published studies (...) % vs 1.1 %), femoral neck (1.6% vs -1.2%), femoral trochanter (3.3% vs -0.7%), and midshaft of the radius (0.2% vs -1.4%). Bone formed during risedronate treatment was histologically normal. The overall safety profile of risedronate, including gastrointestinal safety, was similar to that of placebo. CONCLUSIONS: These data suggest that risedronate therapy is effective and well tolerated in the treatment of women with established postmenopausal osteoporosis who had at least 1 vertebral fracture

2012 RxFiles

258. Delirium in Older People

prescribing practices in a community teaching hospital. J Nurs Care Qual 2005;20:244-50; quiz 51-2. 40. Lundstrom M, Olofsson B, Stenvall M, et al. Postoperative delirium in old patients with femoral neck fracture: a randomized intervention study. Aging Clin Exp Res 2007;19:178-86. 41. Lundstrom M, Edlund A, Karlsson S, Brannstrom B, Bucht G, Gustafson Y. A multifactorial intervention program reduces the duration of delirium, length of hospitalization, and mortality in delirious patients. J Am Geriatr Soc (...) or the inability to lift both arms. Cardioembolic stroke (OR 5.58) and total anterior circulation infarcts (OR 3.42) were more likely to develop delirium. Post-stroke delirium is associated with greater 6 and 12 month mortality, and reduced functional status and higher institutionalisation at 12 months. The usual predisposing factors contributing to delirium apply to surgical patients however some specific risk factors need consideration. Trauma or unplanned surgery such as fractured neck of femur carries

2012 Australian and New Zealand Society for Geriatric Medicine

259. Assessing bone quality through mechanical properties in postmenopausal trabecular bone. Full Text available with Trip Pro

Assessing bone quality through mechanical properties in postmenopausal trabecular bone. The inner structure of trabecular bone is a result of structural optimization provided by remodeling processes. Changes in hormonal status related to menopause cause bone tissue loss and micro-architectural deterioration with a consequent susceptibility to fracture. Accumulation of micro-damage in bone, as a function of the rate of production and rate of repair, underlies the development of stress fractures (...) , increasing fragility associated to age and osteoporosis, especially in transmenopausal women.Quasi-static and nano-dynamic mechanical characterization were undertaken in trabecular bone from femoral neck biopsies of postmenopausal women. AFM (Atomic Force Microscopy) complementary studies were performed to determine nano-roughness (SRa) and the fibrils width of collagen. Nanoindentations were used to quantify transmenopausal changes in intrinsic mechanical properties of trabecular bone: hardness (Hi

2018 Injury

260. Bone microarchitecture, biomechanical properties, and advanced glycation end-products in the proximal femur of adults with type 2 diabetes. Full Text available with Trip Pro

a clinical study to determine whether: 1) bone microarchitecture, AGEs, and bone biomechanical properties are altered in T2D bone, 2) bone AGEs are related to bone biomechanical properties, and 3) serum AGE levels reflect those in bone. To do so, we collected serum and proximal femur specimens from T2D (n = 20) and non-diabetic (n = 33) subjects undergoing total hip replacement surgery. A section from the femoral neck was imaged by microcomputed tomography (microCT), tested by cyclic reference point (...) Bone microarchitecture, biomechanical properties, and advanced glycation end-products in the proximal femur of adults with type 2 diabetes. Skeletal fragility is a major complication of type 2 diabetes mellitus (T2D), but there is a poor understanding of mechanisms underlying T2D skeletal fragility. The increased fracture risk has been suggested to result from deteriorated bone microarchitecture or poor bone quality due to accumulation of advanced glycation end-products (AGEs). We conducted

2018 Bone

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